Living-donor liver transplantation at King Hussein Medical Center : donor complications and outcome in the first 100 donors

Abstract EN

Objective: To present our experience in the first 100 live liver-donors done at King Hussein Medical Center with emphasis on donor postoperative complications and possible risk factors predisposing to complications.

Methods: Over a period of 11 years 100 live-liver donors underwent surgery.

Demographic, clinical and perioperative data of these donors were collected.

Postoperative complications were registered and classified according to the Clavien-Dindo classification.

Statistical analysis was used to identify potential patients’ or grafts’ factors associated with complications.

Results: The mean age of donors was 30.71±7.17 and mean body mass index was 24.50± 2.56.

Three procedures were abandoned after laparotomy.

71 underwent right hepatectomy, 12 right hepatectomy with inclusion of middle hepatic vein, 11 left hepatectomy and 3 left lateral sectorectomy.

The overall complication rate was 36% with most of these being minor grade I and II (26%) complications.

9 patients developed grade III complications while one patient had grade IVa.

The mortality rate was zero.

Older age and higher body mass index were identified as potential risk factors for complications.

Gender, graft type, estimated future liver remnant, inclusion of middle hepatic vein and preoperative biochemical profile were not found in this study to correlate with occurrence of complication.

Conclusion: Strict donor selection and meticulous surgical procedure remain the only modifiable factors in donor hepatectomy.

Continuous transparent clinical audit is mandatory to identify potentially preventable adverse outcomes.